Diagnosis of Lipid Malabsorption in Patients With Chronic Pancreatitis: A New Indirect Test Using Postprandial Plasma Apolipoprotein B-48

Saviana, B.; Quilliot, D.; Ziegler, O.; Bigard, M. A.; Drouin, P.; Guéant, J. L.
November 1999
American Journal of Gastroenterology;Nov1999, Vol. 94 Issue 11, p3229
Academic Journal
OBJECTIVE: This study was done to evaluate a new test for fat malabsorption caused by chronic pancreatitis. Postprandial plasma apolipoprotein B-48 was measured as an indicator of the intestinal assimilation of exogenous lipid. METHODS: Twenty-three patients with chronic pancreatitis, including 19 insulin-treated diabetic patients, were compared with 14 healthy subjects and seven type-1 diabetic patients. Each was given a test meal containing 40 g lipid; the triglyceride apolipoprotein B-48 concentrations in chylomicrons were determined 240 min later. RESULTS: The postprandial chylomicron apolipoprotein B-48 concentrations in the three groups were statistically different at 240 min; pancreatitis versus controls, p < 0.01. and pancreatitis versus type-1 diabetes subjects, p < 0.01. The A plasma apo B-48, the change in apolipoprotein B-48 between 0 and 240 min, was significantly smaller in chronic pancreatitis patients than in controls (p < 0.001) and type-1 diabetes subjects (p < 0.001). The sensitivity of the test was better than 89% for a Δ apo B-48 threshold value of 0.42 mg/dl. CONCLUSIONS: This new indirect test is relatively simple to use and could be practical for evaluating exogenous lipid malabsorption due to chronic pancreatitis.


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